Pain & Progress

The twentieth anniversary of the Faculty of Pain Medicine represents a celebration of co-operation and achievement. From an initial idea to a vibrant faculty of over 400 fellows, the Faculty of Pain Medicine has been a crucial force in the development of the field of pain medicine in Australia, New Zealand, and overseas. The Faculty’s internationally-recognised curriculum has provided practitioners from different specialties with comprehensive training in pain medicine, and ensured that patients receive the treatment and care they deserve.

Despite some initial challenges and setbacks along the way, the Faculty’s role in the evolution of the specialty of pain medicine has been profound. It has been, and continues to be, a training body, it has set standards and created terminology for the specialty, while providing a public voice on social issues relating to pain and its treatment.

Through these actions, the Faculty of Pain Medicine has been pivotal in developing and advancing the field of pain medicine, and continues to be an energising force today.

This exhibition walks through the twenty-year history of the Faculty of
Pain Medicine, from its foundations to now, acknowledging the people who played an influential role in its inception and development, celebrating the major successes, and reflecting on the challenges presented and overcome.

Pre-establishment and Beginnings

The foundations for the Faculty of Pain Medicine (FPM) were quietly laid from 1987, until its official formation in 1998. In the late 1980s Professor Michael Cousins and prominent American pain medicine specialist, Professor John Loeser, worked together to develop “Desirable Characteristics of Multidisciplinary Pain Management Centres”, a document written for the International Association for the Study of Pain. This document was further enhanced in an article in the Medical Journal of Australia, and proved instrumental in developing accreditation and training programs for the fledgling faculty.

The Australian and New Zealand College of Anaesthetists (ANZCA) convened a working party and later, an advisory committee, that began to develop a multidisciplinary faculty focused specifically on pain management. The proposed faculty was to include specialists from ANZCA, the Royal Australasian College of Surgeons, the Royal Australasian College of Physicians including their Faculty of Rehabilitation Medicine, and the Royal Australian and New Zealand College of Psychiatrists. Combining five medical specialties would make the faculty the first of its kind.

The advisory committee recognised that pain management training for nursing, medical, dental and paramedical trainees was inadequate at both undergraduate and postgraduate level. This idea was highlighted by the working party on the management of severe pain, when they reported their findings in “Management of Severe Pain”, published by the National Health and Medical Research Council. As a faculty of a specialist medical college, FPM would be able to directly address some of these inadequacies by providing a training course that would offer formal qualifications for specialists from any of the colleges involved. FPM aimed to occupy a space that to this point had been somewhat under served.

In combination with the training courses, FPM developed an accreditation system for pain clinics. Not only would these service the community’s pain management needs, but they would be a place for trainees to undertake structured and formal training, and sit comprehensive examinations.

The founding members took ideas from the Australian Pain Society (APS), the International Association for the Study of Pain (IASP), and the American Pain Society. They consulted broadly across all medical disciplines in Australia and New Zealand for input into the development of a curriculum for a registerable qualification in pain management, and co-opted members from the APS and also the New Zealand Pain Society.

No stone was left unturned when it came to seeking advice on how to proceed. From this consultation process, it quickly became apparent that pain medicine throughout Australia and New Zealand was lacking in uniformity, and there was previously no clear direction on how to integrate and implement different approaches into standardised practice. This represents the gap that FPM sought to fill.

Based on the preceding years of work and research into pain management, the Joint Advisory Committee on Pain Management (JACPM) submitted a proposal for the formation of FPM in March 1998.

Through a laborious process of going through the proposal “line by line”, all concerns were addressed. The outcome of that meeting was that the Faculty of Pain Medicine officially came into being.

The inaugural board conducted its first meeting by teleconference on 23 November 1998. This meeting also provided an opportunity to officially wind up the JACPM which was now redundant.

They had their first face-to-face meeting at ANZCA almost three months later. The board made an initial call out for foundation fellows, with 47 applicants meeting the criteria.

These foundation fellows needed to provide documentation from their hospital confirming their participation in specialist pain medicine practice, evidence of their contribution to the field of pain medicine through activity in societies like the APS and IASP. They also had to demonstrate that they had experience in teaching and assessing students, and had published and/or presented in the field.

The foundation fellows, and initial board of eleven members, provided strong grounds from which FPM could grow and gain both national and international recognition for its contribution to the field of pain medicine.

From the outset, FPM was to be a multi-disciplinary venture, including fellows from five specialist medical colleges; anaesthetists, surgeons, psychiatrists, physicians, and practitioners of rehabilitation medicine. This idea was revolutionary. Internationally, FPM was the first specifically focused pain medicine group that included fellows from across multiple disciplines. Where pain management was underdeveloped in certain disciplines, FPM could play a constructive role in bridging the gap and bringing participating practitioners in line with the most up to date information and methods in the field. As it drew fellows from five different colleges, it could be a leading voice across multiple specialties, and cross disciplinary boundaries in a way that was not usually possible.